Organization
TANESTHESIA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA ANN NALLS CRNA (PRESIDENT)
(870) 687-3985
Entity
Organization
Contact information
Practice address
638 CALIFORNIA AVE SW, CAMDEN, AR 71701-4604
(870) 836-1000
Mailing address
249 DALLAS 262, SPARKMAN, AR 71763-8690
(870) 678-3985
(870) 678-2105
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C01505
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY
AR
05
—
156044001
—
AR
01
—
1659438448
INDIVIDUAL NPI
AR
Enumeration date
04/07/2007
Last updated
05/21/2020
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